Meibomian Gland Dysfunction Treatment
Meibomian Gland Dysfunction treatment depends on the severity and is tailored to each individual, based on contributing factors. It is important to remember that there is no quick fix for MGD, it requires on-going management. However just like brushing your teeth, treatment can become a simple part of daily routine.
Professional in-house treatments for MGD can be very effective, however results are maintained by continuing to do the at-home treatments.
A treatment plan for MGD usually consists of one or more of the following:
Warm Compresses and Lid Massage
Use a warm compress on your eyes for 15 minutes at least once a day – preferably before sleep.
A specially designed compress such as a Bruder pack
is ideal. A towel or face washer soaked in hot water is NOT an appropriate compress as it does not warm the glands enough to be effective. Following the warm compress, eyelids should be massaged to express the oil.
This treatment can also be combined with blink training. The techniques involved can be explained by one of the optometrists at The Eye Practice.
The modern western diet has seen a significant shift from omega 3 oils (in oily fish, flax etc) to omega 6 (in seeds and vegetables). This shift is believed to have caused changes in how our bodies’ cells are made up. These changes have lead to a range of health problems. Increasing omega 3s in your diet, or taking an omega 3 supplement, has been shown to have anti-inflammatory properties and may help with MGD (2). Always talk to your GP about increasing the dose of omega-3s, as they thin the blood and increase the effect of some blood-thinning medications.
Eye Lid Hygiene
Bacteria live in the crust that forms on the bases of your eyelashes, so it is essential to effectively remove them. At The Eye Practice, we recommend using a proprietry product to effectively dissolve the crusts that build up along the edges of your eyelids.
We stock Blephadex and HypoChlor for home use. These products contain ingredients which kill the specific bacteria that cause blepharitis.
It is usually recommended to use lid scrubs daily for several weeks to get the problem under control.
Just like our teeth need a professional clean every 6-12 months, so too do our eyelids. BlephEx is a fast, simple and relatively inexpensive in-house deep-clean treatment. It eliminates the build-up of bacteria and crusting that at-home cleaning leaves behind.
BlephEx can also be a great preparation for LipiFlow treatment.
Environment and Glasses
Increasing humidity and improving work stations provides symptomatic relief from eye irritation and dryness. Simply wearing a pair of glasses increases the humidity around the eyes, thus helping relieve symptoms. The added benefit of prescription glasses is of course clear vision, reduced eye strain, and the latest spectacle lenses also help block the damaging blue light from digital devices from entering our eyes (read more about eye strain and blue light here).
Sometimes eye drops can help with dry eyes, however it is important to avoid the drops that can make dry eye worse. An optometrist at The Eye Practice can recommend appropriate drops to use which will help with dry eyes rather than make them worse.
Optimel (Manuka Honey) Eye Gel
Manuka honey is a type of honey from bees that almost exclusively forage on the Manuka or tea tree plant in Australia and New Zealand. It contains anti-bacterial elements that seem to be effective against the bacteria that contribute to Dry Eye and Meibomian Gland Dysfunction.
A recent study has shown that Optimel gel improves signs and symptoms of MGD significantly more when used in combination with warm compresses, compared to just using warm compresses alone (3).
It is important to use the gel form rather than the drop form, because the gel contains higher concentrations of the active ingredients and is preservative-free.
Prescription anti-inflammatory eye drops
Often, over-the-counter eye drops are not capable of reducing the inflammation that comes with moderate to severe Dry Eye and MGD. Usually these drops need to be compounded in order to be of the correct dosage and preservative-free.
Optometrists at The Eye Practice are therapeutically endorsed to write prescriptions for eye drops that can calm down the inflammation rapidly and improve Dry Eye symptoms dramatically.
Oral medications for Meibomian Gland Dysfunction
Sometimes MGD requires a temporary course of oral antibiotics to improve symptoms. The antibiotics work to decrease the bacteria on the surface of the eye, and also improve Meibomian gland oil quality. The traditional antibiotic used is called Doxycycline (4), however some recent research had shown that a different antibiotic called Azithromycin may be more effective (5).
In recent years there has been more and more evidence to suggest that our gut health can influence the health of our whole body, not just our digestion.
Probiotics are particularly helpful for people with facial and/or ocular rosacea, one of the causes of Meibomian Gland Dysfunction.
The probiotic helps line the gut with healthy bacteria that reduce inflammation and skin flare ups – in turn reducing Dry Eye symptoms. It is important to find the right probiotic – many probiotics sold in pharmacies do not contain an adequate quantity of good bacteria.
Ultrabiotic products by BioCeuticals contain a high level of good bacteria. The bottles must be kept refrigerated, and it is recommended to take 2 capsules per day (e.g. 1 in the morning and 1 at night).
LipiFlow unblocks Meibomian Glands, improves oil secretions and provides symptom relief. At The Eye Practice, all Dry Eye patients have a non-invasive assessment of their tear film oil level and oil glands to assess the chance of success with LipiFLow.
As LipiFlow is not a cure for MGD, it is important for patients to continue with their at-home treatments.
Intense Pulsed Light (IPL) Therapy
IPL is used for a variety of cosmetic skin conditions, including acne rosacea. It has also proven to be effective in improving Meibomian Gland secretions and treating MGD (6) (7).
It is quick and painless, and requires a series of at least 3 treatments to be most effective. Results are usually immediate and cumulative